<form id="edit-form" class="form-horizontal form-ajax" role="form" data-toggle="validator" method="POST" action="">
    {:token()}
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Parent')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[pid]', $itemdata, $row.gradeid, ['class'=>'form-control'])}
        </div>
    </div>
    <div class="form-group">
        <label for="itemname" class="control-label col-xs-12 col-sm-2">{:__('Itemname')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input type="text" class="form-control" id="itemname" name="row[itemname]" value="{$row.itemname|htmlentities}" />
        </div>
    </div>
    <div class="form-group">
        <label for="itemintro" class="control-label col-xs-12 col-sm-2">{:__('Itemintro')}:</label>
        <div class="col-xs-12 col-sm-8">
            <textarea class="form-control" id="itemintro" name="row[itemintro]" rows="3">{$row.itemintro|htmlentities}</textarea>
        </div>
    </div>
    <div class="form-group">
        <label for="itemprice" class="control-label col-xs-12 col-sm-2">{:__('Itemprice')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input type="number" class="form-control" id="itemprice" name="row[itemprice]" value="{$row.itemprice|default='0'}" />
        </div>
    </div>
    <div class="form-group">
        <label for="itemtime" class="control-label col-xs-12 col-sm-2">{:__('Itemtime')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input type="time" class="form-control" id="itemtime" name="row[itemtime]" value="{$row.itemtime}" step="60" />
        </div>
    </div>
    <div class="form-group">
        <label for="grade" class="control-label col-xs-12 col-sm-2">{:__('Grade')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[grade]', $gradeList, $row.grade, ['class'=>'form-control'])}
        </div>
    </div>
    <div class="form-group">
        <label for="clinicid" class="control-label col-xs-12 col-sm-2">{:__('Clinicid')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:build_select('row[clinicid]', $clinicdata, $row.clinicid, ['class'=>'form-control', 'data-rule'=>'required'])}
        </div>
    </div>
    <div class="form-group hidden layer-footer">
        <div class="col-xs-2"></div>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
